Changing the Balance of Power

Early in my career as a physician, I took care of a woman who died from complications of an abortion procedure.

The patient had traveled to the blue state where I practiced, from a red state where she lived that restricted abortion access, to obtain care she couldn’t find or afford at home. She had previously gotten a procedure performed by a reckless physician who ultimately went to jail for several counts of murder.

She had survived being a refugee from a country that viciously and routinely violated human rights, only to die in an ICU a few months after her arrival in the US. Our team kept her on life support until her family could arrive, when care was withdrawn at their request.

As the US Supreme Court stands on the precipice of overturning Roe vs. Wade, and multiple states consider legislation criminalizing women who decide they must terminate their pregnancies, I cannot stop thinking about this woman and her family. We are about to enter a world where tragedies like this will become far more common.

What is this world, and how did we get here?

The degree to which our country has become polarized on the issue of a women’s right to determine her own reproductive health choices is extreme, but this isn’t about political views. It is about power.

We live in a country, and in a world, where power is concentrated in the hands of  very few. While there are many powerful people who use their influence for positive change, it only takes a few to make catastrophic decisions that affect people with no power, no voice. The powerful are usually men. The powerless are disproportionately women, people of color, poor people without resources.

The women who will most feel the pain and consequence of being stripped of their rights to decide whether, when and how to have children are mainly poor women, black and brown women. If Roe vs. Wade is overturned by the Supreme Court and many states follow through with plans to ban or greatly restrict access to legal abortion, women from these red states will consider traveling long distances to obtain reproductive health services in states that still have safe, legal access to abortion.

The hurdles may be insurmountable in many cases.

Rich women in blue states will likely continue to enjoy these rights, at least for now, perhaps until the powerful reach for even more control.

Look around the world and we see this dynamic playing out on a terrifying scale: In Ukraine, where Vladimir Putin’s thirst for power has made civilian targets of women and children, who are killed, orphaned, trafficked and sold. In Afghanistan, where last weekend the Taliban government ordered women to remain covered in public or their male relatives would be jailed. The list is long.

And yet, we have power too. We have platforms to galvanize our industry as a whole to stand up for those who cannot stand up for themselves.

It is our duty.

It is in fact also our mission (or should be) to improve the health of everyone equally.

We can and should offer generous benefits to our employees living in states that are likely to restrict abortion to obtain the care they need if they have to travel.

We can choose to open subsidiaries and start companies only in locations that will continue to provide reproductive healthcare, and shift away from those that do not.

We can donate money and time to organizations providing aid inside Ukraine and to Ukrainian refugees, and to those working to lift people out of poverty in our own communities.

We can diversify our own leadership by including more women and people with different racial, ethnic and socioeconomic backgrounds on our boards and in our C suites.

We can make our medications and technologies accessible to everyone regardless of their ability to pay.

We must vote.  

These actions may seem disjointed but they are not: they are tied together by giving power and resources back to people from whom it has been denied. They matter. They will add up. They will create a power counterbalance at a time where we cannot afford to stay silent.

I think of my son and daughter, and wonder, like all mothers do, what kind of country and world they will ultimately find themselves in, and how they might use their own power to help shape a better one.

Nothing I could have done would have changed the outcome for my patient or her family all those years ago. But I remember her, and tell her story, so that we can all remember how real this is, and how perilously close we are to a world where all choice is stripped away. Stand up.